Global economic exchange and trade have led to the expansion of English for Specific Purposes (ESP) courses in many Asian higher education institutions. A similar demand for ESP course design is observed in the Cambodian higher education context, mainly triggered by the ASEAN economic integration in 2015, which introduced English as the working language of the ASEAN member countries. Despite the development of ESP courses in the Asian region, research on how ESP course development addresses Asian student needs remains limited. To address this gap, this study examined the perceptions of both academic and industry stakeholders on challenges and measures needed for designing an ESP course in the field of STEM in a Cambodian tertiary institution. Data were obtained using document analysis and semi-structured interviews with 24 stakeholders, which were thematically analysed. Several challenges were reported, which comprised shortage of appropriate ESP training for teachers, lack of teacher motivation, students’ low English proficiency and difficulties in materials development for that context. The study discusses recommendations for ESP course design in STEM in the higher education context in Cambodian and other Asian EFL contexts with similar circumstances.